Contribution of Mental Health Service User Groups to Mental Health Services and Policy in Ghana : The Case of Mental Health Society of Ghana

RESUMO: Este estudo procurou documentar a perspectiva (s) dos utentes de saúde mental e das associações de prestadores de cuidados sobre a prestação, o papel e a contribuição de serviços de saúde mental da comunidade tal como foram percebidos por um número de informadores-chave, incluindo os utentes do serviço mentais e os próprios prestadores de cuidados. O caso específico da Sociedade Saúde Mental do Gana (MEHSOG) foi o foco deste estudo. O modelo foi o de um estudo de caso, utilizando discussões de grupo e entrevistas com informadores-chave como instrumentos de recolha de dados. Estas ferramentas de colheita de dados foram complementadas por observações dos participantes e pela revisão de documentos da MEHSOG e dos vários grupos de apoio da comunidade de auto-ajuda que compõem a associação nacional. O estudo revelou que os utentes dos serviços de saúde mental e seus prestadores de cuidados constituem um importante grupo de partes interessadas na prestação de serviços de saúde mental da comunidade e no desenvolvimento de políticas que tenham em conta as necessidades e os direitos das pessoas com doença mental ou epilepsia. O envolvimento da MEHSOG promove a mobilização de membros e famílias relacionadas com a doença mental de beneficiar de serviços de tratamento bem organizados com um impacto significativo na melhoria da saúde e da participação dos utentes dos serviços e seus prestadores de cuidados primários em processos de tomada de decisão da família e na comunidade processos de desenvolvimento. Os utentes dos serviços por beneficiarem de tratamento, e os prestadores de cuidados primários, por se tornarem mais livres e menos sobrecarregados com a responsabilidade de cuidar, podem passar a envolver-se mais em atividades que melhoramo seu estado, o de suas famílias e das comunidades. A advocacia dos membros da MEHSOG para conseguir que a “Mental Health Bill” se transforme numa Lei foi também um desenvolvimento significativo resultante da participação ativa dos utentes do serviço em chamar a atenção para uma nova e inclusiva legislação de saúde mental para o Gana. Entre os fatores e oportunidades que permitiram aos utentes dos serviços de saúde mental e aos prestadores de cuidados primários de pessoas com doença mental apoiar activamente a prestação de serviços de saúde mental comunitária e o desenvolvimento de políticas conta-se a contribuição da sociedade civil do Gana, particularmente o movimento da deficiência, e os esforços anteriores de ONGs em saúde mental e dos profissionais de saúde mental para ter uma nova lei em saúde mental. Observámos um certo número de desafios e barreiras que actuam de forma a limitar a influência dos utentes dos serviços de saúde mental na provisão da saúde mental comunitária e no desenvolvimento de políticas. Entre elas o estigma social contra a doença mental e pessoas com doença mental ou epilepsia e seus cuidadores primaries é um factor chave. O estigma tem alterado a percepção e as análises do público em geral, especialmente dos profissionais de saúde e das autoridades políticas afetando a priorização dos problemas de saúde mental nas políticas e programas. Outro desafio foi a deficiente infra-estrutura disponível para apoiar serviços de saúde mentais que assegurem aos utentes permanecerem em bom estado de saúde e bem-estar para serem advogados de si próprios. A recomendação do presente estudo é que os movimentos de utentes dos serviços de saúde mental são importantes e que eles precisam de ser apoiados e encorajados a desempenhar o seu papel como pessoas com experiência vivida para contribuir para a organização e prestação de serviços de saúde mental, bem como para a implementação, monitorização e avaliação de políticas e programas. ------------------------------------ ABSTRACT: This study sought to document the perspective(s) of mental health users and care-givers associations in community mental health service provision and their role and contribution as it was perceived by a number of key informants including the mental service users and care-givers themselves. The specific case of the Mental Health Society of Ghana (MEHSOG) was the focus of this study. A case study approach was used to with Focus Group Discussions and Key Informants Interviews being the data collection tools that were used. These data collection tools were complemented by participant observations and review of documents of the MEHSOG and the various community self-help peer support groups that make up the national association. The study revealed that mental health service users and their care-givers constitute an important stakeholder group in community mental health service provision and development of policies that factor in the needs and rights of persons with mental illness or epilepsy. MEHSOG’s involvement in mobilising members and education families to come forward with the relations with mental illness to benefit from treatment services were well made a significant impact in improving the health and participation of service users and their primary carers in family decision-making processes and in community development processes. Service users, on benefiting from treatment, and primary care-givers, on becoming freer and less burdened with the responsibility of care, move on to engage in secure livelihoods activities, which enhanced their status in their families and communities. The advocacy MEHSOG members undertook in getting the mental health Bill become Law was also noted as significant development that was realised as a result of active involvement of service users in calling for a new and inclusive mental health legislation for Ghana. Enabling factors and opportunities that enabled mental health service users and primary care-givers of people with mental illness to actively support community mental health service provision and policy development is with the vibrant civil society presence in Ghana, particularly the disability movement, and earlier efforts by NGOs in mental health in Ghana long-side mental health professionals to have a new law in mental health. A number of challenges were also noted which were found to limit the extent to which mental health service users can be influential in community mental health service provision and policy development. Key among them was the social stigma against mental illness and people with mental illness or epilepsy and their primary carers. Stigma has affected perceptions, analyses of the general public, especially health practitioners and policy authorities that it has affected their prioritisation of mental health issues in policies and programmes. Another challenge was the poor infrastructure available to support enhanced mental health care services that ensure mental health service users remain in a good state of health and wellbeing to advocate for themselves. The recommendation from the study is that mental health service user movements are important and need to be supported and encouraged to play their role as persons with lived experience to inform organisation and provision of mental health services as well as design and implementation, monitoring and evaluation of policies and programes.

The relationship between the education level of successor's and the firm performance in German publicly listed family firms- an empirical analysis

The purpose of this thesis is to investigate how far the education level of the second or third generation of publicly traded German family firms affects the post-succession firm performance. By conducting a correlational and regression design, the aim is to examine how several variables influence the performance of family firms. Performance measures, for example ROA and Tobin’s q and variables, like Education level and succession periods, examine analytically that a positive succession trend will occur. However, with the used model, only a less rigid model shows empirical evidence.

The reasons behind the progression in PISA scores: An education production function approach using semi-parametric techniques

Research Masters

The impact of PBL on transferable skills development in management education

Attention to transferable skills is growing in higher education. Problem-based learning (PBL) is increasingly used in management education for its promising potential to, amongst others, promote transferable skills, including problem-solving, critical thinking and teamwork skills. However, this relationship is seldom assessed. In this study, I use structural equation modelling to examine the effectiveness of PBL, measured through students’ perceptions of satisfaction and skills development. Results show the development of transferable skills is explained by interaction with tutors and a host company, and defining teamwork rules. Satisfaction is explained by skills development, assessment issues, defining teamwork rules and understanding how organisations work. I draw conclusions and recommendations.

Sustainability education in PBL education: the case study of IEM-UMINHO

Sustainability-related skills are becoming more and more relevant for a proficient and professional engineering practice. Industrial engineers in particular, given their broad field of intervention and being at the heart of industrial activity, hold a great deal of potential and responsibility in providing and delivering best industrial practices, that support enhanced industrial systems and products. Therefore making a real contribution in generating wealth and income for all the companies’ stakeholders, including local communities, as well as adding up to more sustainable ecosystems. Previous work by the authors focused on studying the inclusion of this subject on the education of industrial engineers, especially through active-learning methodologies, as well as presenting results on the use of one such approach. The study conducted tried to identify the impacts on sustainability learning using a given specific activity, i.e. a workshop on industrial ecology, held in the 2014/2015 academic year on the Integrated MSc degree on Industrial Engineering and Management at the University of Minho, Portugal. The study uses content analysis of student teams’ reports for two consecutive academic years. The former did not include one such workshop, while the latter did. The Fink taxonomy was used in the discussion of results and reflection. The study outcomes aimed at supporting decision making on worthiness of investment on similar education instruments for sustainability competency development. Some results of the study highlight that: (1) the workshop seem to globally have a positive contribution on the sustainability learning; (2) a number of dimensions of the Life cycle design strategy wheel was developed, but the approach was not broadly used, (3) There was a mismatch on the workshop schedule; (4) students enjoy the workshop; (5) a clearer endorsement on relevance of this aspect is required. Suggestions for future work are also issued.

Pervasive business intelligence platform to improve the quality of decision process in primary and secondary education – A Portuguese case study

Business Intelligence (BI) can be seen as a method that gathers information and data from information systems in order to help companies to be more accurate in their decision-making process. Traditionally BI systems were associated with the use of Data Warehouses (DW). The prime purpose of DW is to serve as a repository that stores all the relevant information required for making the correct decision. The necessity to integrate streaming data became crucial with the need to improve the efficiency and effectiveness of the decision process. In primary and secondary education, there is a lack of BI solutions. Due to the schools reality the main purpose of this study is to provide a Pervasive BI solution able to monitoring the schools and student data anywhere and anytime in real-time as well as disseminating the information through ubiquitous devices. The first task consisted in gathering data regarding the different choices made by the student since his enrolment in a certain school year until the end of it. Thereafter a dimensional model was developed in order to be possible building a BI platform. This paper presents the dimensional model, a set of pre-defined indicators, the Pervasive Business Intelligence characteristics and the prototype designed. The main contribution of this study was to offer to the schools a tool that could help them to make accurate decisions in real-time. Data dissemination was achieved through a localized application that can be accessed anywhere and anytime.

Changes in institutional governance and management of higher education in Laos: National University of Laos

PhD thesis in Educational Sciences (specialization in Politics of Education).

Adult learning and education policies in Germany, Portugal and Sweden: An analysis of national reports to CONFINTEA VI

The chapter presents a theoretical proposal of three analytical models of Adult Learning and Education (ALE) policies. Some analytical categories and the corresponding dimensions are organised according to the ALE rationale which is typical of each social policy model. Historical, cultural and educational features are mentioned in connexion with the different policy models and its interpretative capacity to making sense of policies and practices implemented in Germany, Portugal and Sweden. !e analysis includes the states of the art and the official representations of ALE produced by the respective national authorities through national reports which were presented to CONFINTEA VI (2009).

The importance of the category of consciousness and education for sustainability in methodologies for eco‐efficiency in school buildings

This document reports the importance of the category of consciousness and education for sustainability in the school environment. Education in school has a potential to make the benefits of the building construction visible for society and media, showing to the students, parents and communities how sustainability in built environment could improve the people life in economic, social and environment aspects. Thus, this paper addresses the main events related to sustainability, such as the Stockholm Conference, the Brundtland report, United Nations Conference on Environment and Development (UNCED) and Agenda 21, until reaching the necessity of the elaboration of Methodologies for environmental assessment of building, and later, the development of the specific methodologies according to the buildings. It is also described some examples of sustainability in schools in Germany, Finland and Italy and what kind of sustainable systems those countries are currently using.

O ensino de canto nos ramos genérico e vocacional no 1º ciclo do ensino básico: um estudo de caso múltiplo

Tese de Doutoramento em Estudos da Criança (área de especialização em Educação Musical).

Does dosage in abstinence education matter?

Although past reviews uniformly criticized the efficacy and effectiveness of sexual abstinence in adolescents, new studies dispute the earlier findings. Studies that unpackage intervention programs provide one means of understanding why they succeed in some settings and not in others. This study examined 3183 students spread over 35 schools on the number of hours that they received in sexual abstinence education, in a context of health behaviors promotion. A multi-level analysis (HLM) was performed. The number of hours did not appear to make any difference in the outcome scores. Reasons for this finding are presented and their implications are provided.

Impact of health legislation on the sale of anorectics in a city in the Amazon region

OBJECTIVES: The International Narcotics Control Board released its 2005 annual report, highlighting the Brazil population as one of the largest consumers of anorectics. In Brazil, the National Health Surveillance Agency issued the resolution RDC 58/2007 in order to control the prescription and sale of such drugs. In Belém, the biggest city in the Brazilian Amazon region, this resolution came into force in 2008, leading to inspections of drugstores and magistral pharmacies. The aim of this work was to evaluate the consumption of psychotropic anorectic drugs and the impact of RDC 58/2007 on the prescription and dispensing of anorectics in drugstores and magistral pharmacies in Belém. METHODOLOGY: A retrospective quantitative and descriptive study was conducted of records from the Municipal Department of Health Surveillance of Belém, for 2005 to 2008. The differences in findings were regarded significant when p < 0.05. RESULTS: A total of 1,641 balance sheets of drugstores and magistral pharmacies were analyzed. Amfepramone was the most dispensed medication, followed by fenproporex and mazindol. The highest consumption of anorectics occurred in magistral pharmacies. In 2008, there was a significant reduction in dispensing of anorectics, in drugstores as well as in magistral pharmacies. CONCLUSIONS: This study showed that there was a decrease in the dispensing of anorectics after RDC 58/2007 came into force, and that the magistral pharmacies dispensed more of these drugs. This resolution is a remarkable tool in health control, where it is of great benefit to public health and contributes substantially to the rational use of medicines in Brazil.

Preschool education in Brazil: does public supply crowd out private enrollment?

Expanding access to preschool education is a particularly important policy issue in developing countries, where enrollment rates are generally much lower, and where private institutions constitute a much larger share of the formal preschool sector, than in developed countries. This paper examines if an expansion in the supply of public preschool crowds-out private enrollment using rich data for municipalities in Brazil from 2000 to 2006, where federal transfers to local governments change discontinuously with given population thresholds. Results from a regression-discontinuity design reveal that larger federal transfers lead to a significant expansion of local public preschool services, but show no evidence of crowding-out of private enrollment, nor of negative impacts on the quality of private providers. This finding is consistent with a theory in which households differ in willingness-to-pay for preschool services, and private suppliers optimally adjust prices in response to an expansion of lower-quality, free-of-charge public supply. In the context of the model, the absence of crowding-out effects of more public preschool providers can be rationalized by the existence of relatively large differences in willingness-to-pay for preschool services across different demand segments. Our theoretical and empirical findings therefore suggest that in developing country settings characterized by relatively high income inequality, an expansion in public preschool supply will likely significantly increase enrollment among the poorest segments of society, and need not have adverse effects on the quantity or quality of local private supply.

Girls out of school. State, culture and education in poor rural Lao People's Democratic Republic

Tese de Doutoramento em Sociologia

Alfabetização de jovens e adultos no estado do Rio de Janeiro, Brasil: o significado de um desafio para a inclusão social

Tese de Doutoramento em Ciências da Educação